Abstract
Introduction: The use of non-invasive mechanical ventilation (NIMV) in patients with stable COPD has been a subject of debate for many years. Higher levels of pressure support showed better results. It is still not clear the impact of NIMV in preventing respiratory exacerbations in a stable setting.
Aim: Evaluate the impact of NIMV on respiratory exacerbations and hospital admissions, during a period of one year after NIMV initiation in a group of stable COPD patients.
Methods: Retrospective study of a 4 years period with 37 COPD patients included which fulfilled the criteria to start home NIMV (optimized therapy and paCO2>55mmHg or 50<paCO2<54mmHg with ≥2 exacerbations per year with respiratory acidosis needing NIMV). Other concomitant respiratory disorders were excluded. Pulmonary function, blood gas values and ventilatory parameters were assessed at NIMV titration and one year after.
Results: Mean age was 70.59 ± 8.56. Mean pulmonary function values: FVC% 56.58 ± 19.02; FEV1% 31.13 ± 12.31. Mean IPAP (19.11±3.42cmH2O) and EPAP (6.14±1.06cmH2O). We found a decrease in median exacerbations number vs the previous year: 1.0 (0.0/3.0) vs 0.0 (0.0/2.0) and also in median number of hospital admissions: 1.0 (0.0/2.0) vs 0.0 (0.0/1.0) (p<0,05). Before NIMV adaptation, 68% of the patients had ≥2 exacerbations (or at least 1 hospital admission) per year. After one year of NIVM this number decreased to 41%(p<0.05). A significant reduction in the hypercapnia (median of 56.75mmHg to 46.7mmHg) was seen.
Conclusion: The use of NIMV in stable COPD patients seems to have a positive impact on the reduction of respiratory exacerbations and hospital admission.
- Copyright ©ERS 2015
